| NPI | 1285626259 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: CA 12840T) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: NV 612) |
| Enumeration Date | 2005-08-16 |
| Last Update Date | 2021-08-02 |